Stages of Bladder Cancer

Bladder cancer is a type of cancer that begins in your bladder. When you are diagnosed with the condition, the stage of the cancer will also be determined using many different tests and exams. This information will help your doctor to come up with the best possible treatment plan for you.

There are two different types of stages for bladder cancer. The clinical stage is based on how much the cancer has grown or spread. This is determined based on physical exams, biopsies, cystoscopies, and imaging tests. The clinical stage is what is used to determine the plan of treatment.

The pathologic stage is determined after surgery is performed. Sometimes the cancer has actually spread further than the clinical stage had previously estimated, but pathologic staging is usually much more accurate since doctors are able to get a first-hand look at the extent of the cancer.

The TNM System

The staging system that is used for bladder cancer is called the TNM system, and it was created by the American Joint Committee on Cancer (AJCC). This staging system is primarily based on three important pieces of information. These include:

  • Tumor (T): This part of the system describes the primary tumor. Has it grown through the bladder wall? Has it spread into the nearby tissues? The tumor is assigned a number of 0 through 4 based on how far it has spread. There are different kinds of tumors that can develop in the bladder. Papillary carcinomas are slender, finger-like projections from the inner surface of the bladder toward the hollow center. Since these kinds of tumors usually grow toward the middle of the bladder, they typically don’t grow into the deeper bladder layers, which means they often receive a good prognosis. Flat carcinomas don’t grow toward the center of the bladder. Instead, they grow on the inner layer of bladder cells, but can also grow into the deeper layers of the bladder, which would be called an invasive transitional cell carcinoma.
  • Lymph nodes (N): This category addresses if the cancer has spread to regional lymph nodes. This includes the lymph nodes near the bladder and long the common iliac artery. This category ranges from 0 to 3 depending on how many lymph nodes are affected.
  • Metastasization (M): If the cancer has spread to distant lymph nodes or organs, then this means it has metastasized. For this category, it is basically assigned no (0) or yes (1) to answer the question of if the cancer has metastasized or not.

After each category of the TNM staging system is determined, the information is combined to create the overall stage of the cancer. The stages of bladder cancer begin with stage 0 (early) and end with stage IV (advanced).

Once you have been properly diagnosed and your cancer has been assigned a stage, your treatment is able to begin. You and your doctor will both figure out which treatment plan will work best for you depending on your type and stage of bladder cancer, as well as your overall health and personal preferences.

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Posted on May 5, 2023